En bloc explant with lift 1 year ago gone wrong, why are my breasts deformed? (Photos)

The pectoralis muscle can't be repaired after dual plane or split technices, that's a legend, a myth, unfeasible no matter what you read or are told, the muscle shortens and can't be reattached, however this is not the cause of your deformity, I'll be on spot and brief:
-the surgeon failed to release the lower edge of the pectoralis muscle from the breast skin, that's why... you didn't tell us but I know well this problem is affecting you... you have animation deformity, when you contract the pectoralis you develop an awful and awkward deformity; solution: releasing the muscle and splitting it from the skin, easy as it sounds, unbelievable this was not done
-the breat lift pattern, a short inverted T or Wise patter, was unproperly planned and wrongly located, that's why your breasts look odd and square; solution: breast lift pattern revision, note: not another breast life, just a re-design of the pattern.

Your case is not a difficult one, but be sure you are not suggested artificial mesh, fat transfer, new implants, etc, it is cold and dangerous outside there, be wary and cautious, just straightworward technical proposals. No, your skin is not over streched, this is not the cause.

Your results are related to how your expanded skin envelope scarred back down to your chest wall. Unfortunately sometimes these outcomes are unavoidable after someone that has had large breast implants in place for long periods of time. Aggressive massage additional time may help improve your outcome however an acceptable aesthetic outcome may only be achievable with a replacement of your implants. Other options would include fat grafting, however this may take multiple rounds to achieve the desired outcome. An in person consultation with a certified plastic surgeon can give you a personalized treatment plan.

Thanks for your question! I have found that explant with en bloc can create skin deformities and can compromise breast tissue. You may benefit from some fat grafting to help improve the appearance. I would seek out a second or third opinion. Good luck!

hello and thank you for sharing your question with pictures. After a breast implant Surgery breast tissue tends to slight atrophy. After removing the implants we have less tissue to work with for a reconstruction. In your case you have retracting scar because of the lack of fat tissue. Your best option if you don't Desire to place back the implants is to fill the breast with fat transfer. Best of luck

It’s completely understandable to feel disappointed when your surgical results don’t meet your expectations, especially after allowing a full year for healing and adjustments.
In cases of breast implant removal (en bloc explantation) after a long history of having implants—especially sizable implants (like 600cc)—it’s common for the skin and breast tissues to experience stretching and thinning. Once implants are removed, even with a lift, the remaining skin and breast tissues can struggle to retract fully, potentially causing unevenness, indentations, or irregularities.
Factors contributing to these issues typically include: • Skin Elasticity Loss: After many years with implants, the skin’s ability to shrink back can be diminished. • Capsular Contracture or Scar Tissue: This tissue, which forms naturally around implants, can leave behind irregularities even after careful explantation. • Residual Scar Tissue: Scars from previous surgeries, including explant and lift incisions, can contribute to an uneven appearance. • Tissue Atrophy: Long-term pressure from implants may lead to thinning of breast tissue and fat, affecting overall breast shape and volume.
Improvement is often possible with revision procedures, such as fat transfer, secondary breast lift (mastopexy), or even internal tissue repositioning. Non-surgical treatments, such as radiofrequency skin tightening, might offer slight improvements, but significant results typically require surgical revision.
Your best step forward is a detailed in-person assessment with a surgeon experienced specifically in post-explant reconstructive surgery. They’ll provide insights into your unique anatomy and help plan the most suitable next steps.
I hope this helps provide clarity on your situation. For a detailed assessment, consulting your surgeon would be beneficial.
— Güray Yeşiladalı, MD

Loss of Volume & Support
After removing large implants (especially 600cc), the remaining natural tissue may not have enough structure or elasticity to hold a full shape, even with a lift.

Over time, the skin and tissue can sag or collapse inward, creating a “deflated” or uneven appearance.

2. Tissue Thinning from Long-Term Implant Use
After 20 years with implants, especially large ones, your natural breast tissue likely thinned out. This makes it harder for the breast to regain a rounded shape once the implant is removed.

3. Chest Wall or Muscle Changes
Even though your surgeon said no muscle repair was needed, 20 years of dual-plane implants can change the positioning or function of the pectoral muscles.

A “window shading” effect or visible muscle movement might create odd shapes, dents, or shifting.

4. Capsular Contracture or Scarring
Even after an en bloc explant, internal scar tissue from your previous surgeries may remain and cause distortion.
Sometimes scar tissue pulls or puckers the skin in a way that becomes more visible over time.
5. Inadequate Lift or Technique
If the lift wasn’t aggressive enough to reshape and reposition the remaining tissue, or if skin quality was poor, the final result might look empty, sagging, or asymmetrical.
Also, your surgeon may have been conservative to avoid complications, which can lead to underwhelming aesthetic results.

Get a Second (or Third) Opinion
Preferably from a plastic surgeon with experience in revision and post-explant reconstruction.
Bring your surgical records and imaging if available — it helps them assess muscle, tissue, and implant history.
Consider Fat Grafting or Reconstructive Options
Fat transfer can restore volume in a more natural, subtle way.
Some women opt for smaller implants or internal mesh support (like GalaFLEX) if they want more shape without going back to large implants.
3D Imaging or Ultrasound
This can help assess any internal abnormalities, muscle separation, or scarring that might be affecting your outcome.

Giving428826: I am sorry to hear about your struggle following your explant procedure. Unfortunately, with multiple pairs of implants, especially ones as large as the ones you had, the breast and chest wall tissue can get deformed. I think in your case, it might be possible to revise your breast lift to remove a bit more skin. Apart from that, the next move that could help would be natural fat transfer.

The results following an implant removal without replacement, whether "en bloc" or not, will often times leave the skin lose because the pocket has collapsed. When performing this procedure, I will suggest massage and lymphatic drainage within the first post-op week.

Thank you for submitting your questions and photos. I am sorry that having your implants removed did not leave you with a satisfactory outcome. Based on the photos submitted, there could be a couple of reasons as to why your breasts have settled like this. Your breast skin has been stretched out over large implants for a long time and likely won’t return to your pre-implant “look”. Also, the medial aspect of your pec muscles may have detached and are not positioned correctly on the chest wall. Since breast tissue is attached to muscle, the tissue will then not sit in the correct position either. I highly recommend you seek out a board certified plastic surgeon to go over revision options. Good luck and thanks again for reaching out!

Hi Giving,
It appears that you have irregularities related to a few factors including loss of breast tissue (naturally over time/ weight changes/ breastfeeding, from pressure of implants long-term, tissue removed as part of "en bloc" explantation, and possibly even the lift), excess skin, and multiple scars. Fat grafting to the breasts can help fill in some of the deficiencies and give a fuller and smoother appearance to the breasts. Revision of the breast lift may also help distribute the skin more evenly. I recommend that you see a board-certified plastic surgeon well-versed in these techniques to help you restore your breast shape.
Best,
Dr. Zamani